Provider Demographics
NPI:1548958648
Name:DEMEYER, RONALD SEAN (FNP)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:SEAN
Last Name:DEMEYER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 SISTERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CLYO
Mailing Address - State:GA
Mailing Address - Zip Code:31303-3514
Mailing Address - Country:US
Mailing Address - Phone:912-667-8009
Mailing Address - Fax:
Practice Address - Street 1:931 E WINTHROPE AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-1839
Practice Address - Country:US
Practice Address - Phone:478-982-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily